Africa: Nets Are Key to Cutting Malaria Deaths and Illness

New York — Malaria still kills 660,000 people every year, most of them African children. Universal coverage of insecticide-treated bed nets is key in making gains against malaria - one of the largest killers of children in the world in the world, says UNICEF on World Malaria day. With partners, UNICEF champions and supports governments to undertake the free distribution of insecticide-treated nets - especially long-lasting insecticidal nets. When universal coverage - one net for every two people - is reached this simple, effective barrier can reduce child mortality by up to 20 per cent.

In 2004, there were just 5.6 million bed nets in sub-Saharan Africa.

Until recently limited competition among producers meant that they were too expensive to scale up. However, by 2010, bulk buying, joint procurement, better financing and extending manufacturing capacity into Africa meant that this number had increased to 145 million. A sustained, driven focus on high coverage with this very effective anti-malarial intervention contributed greatly to the 1.1 million lives that have been saved and a one-third decline in African malaria mortality rates that have been recorded since 2000.

"It is unacceptable that every day more than 1,500 children still die from a preventable and curable disease," said Nicholas Alipui, UNICEF's Director of Programmes. "We must distribute insecticide-treated nets to all who need them, provide timely testing for children and appropriate medicine when they are infected."

A three-day treatment will cure malaria infections, especially if an episode is diagnosed early enough and treated appropriately - in particular with artemisinin-based combination therapies (ACTs). But many children, especially in Africa, still die from malaria as they do not sleep under insecticide-treated bed nets and are unable to access life-saving treatment within 24 hours of the onset of symptoms.

UNICEF supports national efforts to train and provide community health workers with simple tools such as malaria rapid diagnostic tests so that children receive medicine quickly when needed. However, in Africa the proportion of treated children who receive a first-line treatment such as an ACT is less than 30 percent in most countries.

UNICEF, with governments, donors and other partners, also looks for innovative ways to reach the most vulnerable and hardest to reach children in pursuit of universal coverage. For example, in addition to free net distributions during mass campaigns in the poorest and most remote areas, nets are also provided to children during routine immunizations and to pregnant women during ante-natal check-ups. UNICEF is also stepping up its efforts on integrated community case management, which brings a package of life-saving interventions closer to children, families and homes.

It is estimated that enough nets were delivered over the last decade to cover 80 per cent of requirements in Sub-Saharan Africa. Many nets however are reaching the end of their useful life and must be replaced.

Countries that had already reduced their malaria burdens by up to 50 per cent can quickly detect increased cases and deaths due to malaria if old, worn-out nets are not replaced. From 2000 to 2010, the proportion of children sleeping under an insecticide-treated net in sub-Saharan Africa grew from less than 5 per cent to over a third. But global procurement of long-lasting lasting insecticidal nets has dropped by 52 per cent against an annual target requirement of 150 million. Such a slowdown risks gravely undermining the gains to date. "We have made considerable progress in this fight, but cannot take our eyes off the goal of reducing malaria cases and deaths to zero. We must make sure that countries have the funding they need for malaria control and use it to protect their children and expectant mothers," Mr. Alipui added.

Fighting malaria not only saves the lives of children, but also yields many other health and economic benefits for affected communities. For example, reducing malaria improves the health of pregnant mothers and therefore their newborn babies, reduces school and work absenteeism.

It is estimated there is a 40-fold return for every US$1 spent controlling malaria in Africa.

There have been impressive gains and successes built on strong partnerships and the generous contributions of many donors - but these gains can be quickly lost if sustained focus and investments are not maintained.

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